Which is More Correlated with Hypertensive Organ Damage, Sleep Blood Pressure Assessed by Self-Measured at Home or Ambulatory Blood Pressure Monitoring?: The Japan Morning Surge-Home Blood Pressure (J-Hop) Study

Objective To assess the associations with hypertensive target organ damage (TOD) of sleep SBP assessed by self-measured home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM). Methods Data of 1008 participants in the J-HOP study who measured sleep BP using both HBPM, three times during sleep (2 AM, 3 AM and 4 AM) and ABPM during sleep were analyzed. Study participants were classified into 4 groups according to sleep SBP values: group 1, HBPM <120 mmHg, ABPM<120 mmHg; group 2, HBPM <120 mmHg, ABPM≥120 mmHg; group 3, HBPM ≥120 mmHg, ABPM<120 mmHg and group 4, HBPM≥120 mmHg, ABPM≥120 mmHg. Hypertensive TOD as indicated by brachial ankle pulse wave velocity (baPWV), left ventricular mass index (LVMI) and carotid intima media thickness (IMT), assessed in 946, 876 and 317 participants respectively, were compared among the 4 groups. Results Mean age was 63 ± 11 years. The percentage of male participants was 49.9. Thirty-four, 10, 20 and 36 percent of the participants were classified into groups 1, 2, 3 and 4. For groups 1,2, 3 and 4, respectively, baPWV were 1529 ± 293, 1536 ± 265, 1616 ± 255 and 1710 ± 322 cm/sec, LVMI were 91 ± 23, 94 ± 22, 101 ± 26 and 101 ± 28 g/m 2 , and IMT were 0.73 ± 0.14, 0.72 ± 0.18, 0.79 ± 0.15 and 0.80 ± 0.19 mm. After age, gender and office SBP were adjusted, the baPWV, LVMI and IMT of groups 3 and 4 were significant higher than of group 1, In multivariate analyses, sleep SBP assessed by HBPM was an independent predictor of baPWV, LVMI and IMT, but that assessed by ABPM was an independent predictor of only baPWV. Conclusions Sleep SBP measured by HBPM was more closely associated with baPWV, LVMI and IMT than sleep SBP measured by ABPM.